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Background:In the past years, saprophytic bacteria and candida have been emerging as potential human pathogens causing life-threatening infections in patients with cancer. This study was designed to determine the bacteria and candida species, causing bloodstream infections in cancer patients and the assessment of their susceptibility to antibiotics and biosynthesised silver nanoparticles. Materials and Methods:Ninety-seven microbial pathogens recovered from blood samples of cancer patients were included in the present study. The microbial isolates were collected in a duration period extending from December 2016 to July 2018 at National Cancer Institute, Cairo, Egypt. The clinical samples were collected using microbiological methods and were cultivated on MacConkey agar, blood agar media and Sabouraud dextrose agar media. The microbial isolates were identified using both standard microbiological methods and VITEK 2 compact automated system. The antibiotic resistance pattern was determined by the VITEK 2 compact automatic system and disk diffusion method, according to the Clinical and Laboratory Standards Institute. The characterisation of nanoparticles was carried out using ultraviolet spectroscopy and electron microscope. The antimicrobial activity of bio (AgNPs) was evaluated. Results:A total of 97 microbial isolates recovered from collected blood samples from cancer patients were included in the study. Pathogenic bacteria and Candidawere represented by 74 isolates (76.22%) and 23 isolates (23.69), respectively. Among the 74 bacterial isolates, Escherichia coliconstituted (27.81%), Klebsiella pneumoniae(24.72%), Acinetobacter baummannii(11.33%), Pseudomonas aeruginosa(4.12%), Enterobacterspp. (3.09%) and) Staphylococcus aureus(2.06%). Cedecea davisae(1.03%), Burkholderia cepacia(1.03%) and Pantoea agglomerans(1.03%). Among the 23 Candida isolates, Candida tropicalis constituted(9.27%), Candida albicans(5.15%), Candida glabrata(5.15%) and Candida krusei(4.12%) from the total microbial isolates . The antibiotic susceptibility results revealed that amikacin and gentamycin were the most effective antibiotics against Gram-negative bacteria, while vancomycin and linezolid were most effective against S. aureus. Caspofungin was the most effective against candidaspecies. The obtained stable biosynthesised silver nanoparticles ranged in size from 10 nm to 100 nm and were mostly spherical in shape. These biosilver nanoparticles showed the highest antimicrobial activity against most of the microbial isolates (bacteria and Candida). The in vitrocytotoxicity of biosynthesised AgNPs on HeLa cell lines revealed a dose-dependent potential. The IC50 value of AgNPs was found 6 and 5.6 μg/ml, respectively. Conclusion:The present study revealed a significant distribution of multidrug-resistant microbes, which may increase the burden of healthcare to prevent infections in cancer patients. Biosilver nanoparticles exhibit antimicrobial activity against multidrug-resistant microbes and could be considered as effective agents against these strains.

Antimicrobial resistance is a global public health threat that signals the identification of new antimicrobial agents with different modes of action. The synthesis and the antimicrobial evaluations of a series of 2-oxonicotinonitriles (2-ONNs) derivatives are described. The parent 2-ONN derivative 3was synthesized by one-pot four-component reaction: acetyl cyclohexane, p-anisaldehyde, ethyl cyanoacetate, and NH4OAc, in high yield. Density functional theory geometrical equilibrium of the tautomeric forms of 3concluded the predominance of the keto tautomer. Base-catalyzed coupling of 3with several organohalides/alkylating agents provided branching and solubilizing groups to the 2-ONN derivative 3. Alkylated ONNs and free acyclic nucleoside mimics/glycosides derived from the 2-ONN derivative 3were tested for their antibacterial and antifungal activities. The acyclic nucleoside mimic 13and the N1-propargyl derivative 16and N1-allyl derivative 18showed significant activities against S. aureus, and M. luteus; meanwhile, significant anti-E. coliactivity was observed with compounds 3and 18. On the other hand, a significant antifungal activity was observed with 3and with its N1-glucoside derivatives 4and 5against Candida albicansand Aspergillus niger.

To determine the prevalence of vitamin D deficiency in patients with COPD and bronchial asthma, and the relation of vitamin D serum levels to pulmonary spirometric measures as well as other important clinical parameters that could affect quality of life in these patients.

Thrombin-activatable fibrinolysis inhibitor (TAFI) is a potent inhibitor of fibrinolysis isolated from human plasma. This study was designed to investigate the association between TAFI levels in relation to metabolic control, microvascular complications and lipid profile in a cohort of Egyptian children and adolescents with type 1 diabetes mellitus (T1DM). Eighty normotensive nonobese type 1 diabetic patients (45 with and 35 without microvascular complications) with a mean age of 12.75±3.6 years and mean disease duration of 7.42±2.4 years in addition to 60 sex and age-matched normal individuals were enrolled in this study. Anthropometric measurements, blood pressure and microvascular complications were analysed. HbA1c, albumin-to-creatinine ratio in urine, lipid profile and TAFI levels were measured. Plasma level of TAFI in diabetic patients was significantly elevated, compared with normal individuals (16±2.8 vs. 10.3±0.7gml; P<0.004). Plasma level of TAFI in diabetic patients with microvascular complications was significantly higher than in diabetic patients without complications (17.9±1.8 vs. 12.9±0.6gml; P<0.001). Plasma TAFI levels were positively correlated with HbA1c levels (r=0.38; P<0.03) and SBP (r=0.37; P<0.02). Total cholesterol and triglycerides were higher in patients with microvascular complications than in those without complications (P<0.001, P<0.05, respectively). Our results showed that TAFI is considered a valid predictor for microvascular complications with best cut off value 15gml with sensitivity of 99 and specificity of 100. Our data imply that increased plasma TAFI as well as high lipid levels may be involved in the mechanism of vascular endothelial damage in patients with T1DM. This suggests the possibility of TAFI participating in the mechanism of hypofibrinolysis, hence occurrence of microvascular complications in diabetes.